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Abstract

To the editor: The recent paper by Mathew and associates (Ann Intern Med 82:215-218, 1975), reporting a case of Goodpasture's syndrome without clinical evidence of renal disease, raises several questions concerning interpretation of the data.

The patient was an 18-year-old man with a history of hemoptysis, iron deficiency anemia, and hemosiderin-laden pulmonary macrophages, who was treated with corticosteroids with resolution of the hemoptysis. Despite the absence of hematuria, proteinuria, or renal functional impairment, the patient underwent three renal biopsies in 4 months, all of which failed to show evidence of glomerulitis by light microscopy. On the basis of IgG and